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Objective:The aim of our study was to investigate the lymph node metastasis of mesorectum and ischiorectal foss in ultra-low rectal cancer and its influence on the surgical procedure selection.Methods:Large slices and tissue microarray technology were used to detect metastasis lymph nodes from 23 dissected specimens of ultra-low rectal cancer.Results:415 lymph nodes were detected in the 23 specimens.169 and 59 lymph nodes were metastasis and micrometastasis, respectively.Twelve specimens were diagnosed with lymph node metastasis, while other 4 specimens were with lymph node micro-metastasis.There were 29.0% (49/169) and 17.2% (29/169) metastatic lymph nodes located in the outer and anterior region of mesorectum.There were 2 cases with ischiorectal fossa lymph node metastasis and 1 case with micrometastasis.The 3 metastatic cases were only 13% (13/23) of all the 23 cases.Conclusion:There is regional lymph node metastasis existing in ultra-low rectal cancer.The metastatic incidences in distal mesorectum and ischiorectal fossa are relatively low.Considering Miles operation as the standard surgical procedure for ultra-low rectal cancer should be evaluated renewedly.
Objective: The aim of our study was to investigate the lymph node metastasis of mesorectum and ischiorectal foss in ultra-low rectal cancer and its influence on the surgical procedure selection. Methods: Large slices and tissue microarray technology were used to detect metastasis lymph nodes from 23 dissected specimens of ultra-low rectal cancer. Results: 415 lymph nodes were detected in the 23 specimens. 169 and 59 lymph nodes were metastasis and micrometastasis, respectively. Twelve specimens were diagnosed with lymph node metastasis, while other 4 specimens were with lymph node micro-metastasis. There were 29.0% (49/169) and 17.2% (29/169) metastatic lymph nodes located in the outer and anterior region of mesorectum. There were 2 cases with ischiorectal fossa lymph node metastasis and 1 case with micrometastasis The 3 metastatic cases were only 13% (13/23) of all the 23 cases. Confluence: There is regional lymph node metastasis existing in ultra-low rectal cancer. The metastatic incidences in d istal mesorectum and ischiorectal fossa are relatively low. Conscious Ring Miles operation as the standard surgical procedure for ultra-low rectal cancer should be evaluated renewedly.